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PubMed2002

Serological investigation of Bartonella henselae infections in clinically cat-scratch disease-suspected patients, patients with cardiovascular diseases, and healthy veterinary students in Japan.

Seroprevalence of Bartonella henselae was investigated in Japan in 48 individuals clinically suspected of having cat-scratch disease (CSD), 159 patients with cardiovascular diseases, and 129 healthy veterinary students. Of 48 CSD-suspected patients examined, 19 (39.6%) were positive for B. henselae-IgG and 4 (8.3%) for B. henselae-IgM. Of 159 patients with cardiovascular diseases, 5 (3.1%) were positive for B. henselae-IgG. In healthy veterinary students, 14 of 129 (10.9%) were positive for B. henselae-IgG and 1 (0.8%) for B. henselae-IgM. The positive rates of B. henselae-IgG and -IgM in CSD-suspected patients were significantly higher than in other sources. Most CSD-suspected and healthy individuals who were positive for B. henselae antibody had had some contacts with cats. In CSD-suspected patients, the B. henselae positive rate in females was significantly higher than in males, and high seropositive rates to B. henselae were found in younger age groups.

Adolescent↗
PubMedDate not supplied

Epithelioid angiomatosis.

Since the original description of Epithelioid Angiomatosis by Cockerell and Associates in 1987, literature has been published describing both the local and systemic manifestations of Cat-Scratch disease. Most typical cases of Cat-Scratch disease are self-limited with full recovery expected in 2 to 4 months. In patients infected with the acquired immunodeficiency virus, the prognosis is much less favorable. The authors present a case of a human immunodeficiency virus (HIV)-infected patient with biopsy proven Cat-Scratch disease, his clinical manifestations, and response to therapy.

AIDS-Related Opportunistic Infections↗
PubMed2006

[Prevalence of Bartonella henselae antibodies in Chilean children, adolescents and veterinary workers].

BACKGROUND: Bartonella henselae is the causative agent of cat-scratch disease. AIM: To study the seroepidemiology of Bartonella henselae in healthy Chilean children and in a population with occupational risk. MATERIAL AND METHODS: Serum IgG antibodies were determined by indirect fluorescence technique in 181 children and adolescents and in 107 technical and professional workers involved in the care of cats. Samples with titers equal to or greater than 64 were considered positive. RESULTS: Twenty four (13.3%) children and 11 (10.3%) occupational risk subjects were seropositive. No significant differences by age and gender were observed. CONCLUSIONS: Assuming that seroprevalence indicates level of exposure to Bartonella henselae, these results suggest that this infection is endemic in Chile and, for this reason, the best antibody titer to diagnose acute cat-scratch disease should be higher than the figure recommended by the Centers for Disease Control in the in United States.

Adolescent↗
PubMed1997

Evaluation of commercial slides for detection of immunoglobulin G against Bartonella henselae by indirect immunofluorescence.

Four commercial slides were compared with in-house slides for the detection of immunoglobulin G (IgG) against Bartonella henselae in 58 healthy persons from a rural region by an indirect immunofluorescence assay. MRL-BA slides (MRL Diagnostics, USA) and Virion slides (Virion, Switzerland) with agar-derived Bartonella henselae showed IgG titers of > or = 1:256 in 44.8% and 51.7%, respectively, whereas Bion slides (Bios, Germany), MRL-Vero slides (MRL Diagnostics), and in-house slides with cell-associated Bartonella henselae showed such titers in 3.4%, 5.1% and 3.4%, respectively. The MRL-Vero slides (Bartonella IgG substrate slides, MRL Diagnostics) were further evaluated with 26 patients with cat scratch disease, 20 patients with lymphadenopathy not due to cat scratch disease, 100 blood donors from an urban area, and 120 blood donors from a mixed urban/rural area. In our mixed urban/rural population the IgG titer of 1:256 had a sensitivity of 84.6% and a specificity of 93.4% for the serodiagnosis of cat scratch disease. Seroprevalence was higher in blood donors from the mixed area (50.8%) than from the urban area (37%). MRL-Vero slides were considered useful for the serodiagnosis of cat scratch disease by indirect immunofluorescence and have replaced our in-house system. However, patients with low IgG titers should be retested three to four weeks after initial sampling to demonstrate a possible rise of IgG titers in paired sera.

Antibodies, Bacterial↗
PubMed2004

Bartonella henselae infection presenting as a unilateral panuveitis simulating Vogt-Koyanagi-Harada syndrome.

PURPOSE: To report an unusual ocular manifestation of cat scratch disease. DESIGN: Observational case report. METHODS: Review of the clinical, laboratory, photographic, and angiographic records of a patient with cat scratch disease. RESULTS: A 54-year-old woman presented with counting fingers visual acuity in the right eye associated with optic disk edema, diffuse choroidal thickening, and panuveitis. Fluorescein angiography showed disk leakage and hyperfluorescent spots with late leakage suggestive of Vogt-Koyanagi-Harada disease. She was diagnosed with cat scratch disease by serum antibody titers and clinical course. CONCLUSIONS: Ocular manifestations of cat scratch disease can include diffuse thickening of the choroid. Cat scratch disease may manifest with angiographic features suggestive of Vogt-Koyanagi-Harada disease.

Anti-Bacterial Agents↗
PubMed1999

Clinical and pathologic evaluation of chronic Bartonella henselae or Bartonella clarridgeiae infection in cats.

Human Bartonella infections result in diverse medical presentations, whereas many cats appear to tolerate chronic bacteremia without obvious clinical abnormalities. Eighteen specific-pathogen-free cats were inoculated with Bartonella henselae- and/or Bartonella clarridgeiae-infected cat blood and monitored for 454 days. Relapsing bacteremia did not correlate with changes in protein profiles or differences in antigenic protein recognition. Intradermal skin testing did not induce a delayed type hypersensitivity reaction to cat scratch disease skin test antigen. Thirteen cats were euthanatized at the end of the study. Despite persistent infection, clinical signs were minimal and gross necropsy results were unremarkable. Histopathology revealed peripheral lymph node hyperplasia (in all of the 13 cats), splenic follicular hyperplasia (in 9 cats), lymphocytic cholangitis/pericholangitis (in 9 cats), lymphocytic hepatitis (in 6 cats), lymphoplasmacytic myocarditis (in 8 cats), and interstitial lymphocytic nephritis (in 4 cats). Structures suggestive of Bartonella were visualized in some Warthin-Starry stained sections, and Bartonella DNA was amplified from the lymph node (from 6 of the 13 cats), liver (from 11 cats) heart (from 8 cats), kidney (from 9 cats), lung (from 2 cats), and brain (from 9 cats). This study indicates that B. henselae or B. clarridgeiae can induce chronic infection following blood transfusion in specific-pathogen-free cats and that Bartonella DNA can be detected in blood, brain, lymph node, myocardium, liver, and kidney tissues of both blood culture-positive cats and blood culture-negative cats. Detection of histologic changes in these cats supports a potential etiologic role for Bartonella species in several idiopathic disease processes in cats.

Animals↗
PubMed2004

[Prevalence of Bartonella henselae in stray and domestic cats in different Italian areas: evaluation of the potential risk of transmission of Bartonella to humans].

Bartonella henselae is the major etiological agent of Cat Scratch Disease in humans. Cats act as the natural reservoir of B. henselae and can transmit the infection to humans by bite or scratch. The diffusion of B. henselae was evaluated by seroprevalence and bacteremic status in different stray cat populations located in nine areas of Northern Italy. A total of 1585 cats were tested by blood culture and 361 (23%) resulted bacteremic; 1416 out off 1585 cats were also tested for Bartonella henselae antibodies and 553 (39%) resulted seropositive. The molecular typing of the isolates showed that 26% of bacteremic cats were infected with B. henselae type I, 52% with B. henselae type II, 16% were co-infected with both and 5% infected with B. Clarridgeiae. Moreover 165 domestic cats were tested by blood culture and serological test (IFA test cut-off: 1:64). 35 cats (21%) resulted bacteremic and 49 (43.5%) were seropositive. The molecular typing of the Bartonella isolates of the domestic cats showed that 45% of bacteremic cats were infected with B. henselae type I, 36.5% with B. henselae type II, 12% were coinfected with both and 6% infected with B. Clarridgeiae. For a completely evaluation of health status of the cat for B. henselae infection, the authors suggest both blood culture and serological tests. Nevertheless a nonbacteremic cat with positive serology result should be reevaluated for possible recurrent bacteremia.

Animals↗
PubMedDate not supplied

Pattern visual evoked potentials in eyes with disc swelling due to cat scratch disease-associated neuroretinitis.

PURPOSE: To evaluate optic nerve function by pattern visual evoked potentials (VEPs) in eyes with optic disc swelling due to neuroretinitis associated with cat scratch disease (CSD). METHODS: Four eyes of four patients with marked optic disc swelling resembling optic neuritis but diagnosed serologically as CSD received systemic steroid treatment. VEPs elicited by black and white checkerboard stimuli created on a TV monitor were recorded before the treatment. RESULTS: The visual acuity (VA) in the affected eyes was decreased to 20/50 in two eyes and finger counting in two eyes at their initial visits. Ophthalmoscopic examination revealed neuroretinitis characterized by severe optic disc swelling, chorioretinal exudates, and macular edema in all eyes. Anti-Bartonella henselae serum antibody was markedly elevated in all patients confirming the diagnosis of CSD. The P100 of the transient VEPs was only mildly reduced without a delay in the implicit times in three eyes and only slightly delayed in the other eye. The steady-state VEPs were mildly reduced in two eyes and phase-reversed in other two eyes. The VA fully recovered after systemic steroid treatment in all patients. CONCLUSIONS: Although all examined patients showed marked swelling of the optic disc and visual decrease, the pattern VEPs were not affected as severely as in idiopathic optic neuritis. However, the degree of change of the pattern VEPs varied among patients.

Adult↗
PubMed2006

Disseminated Bartonella infection following liver transplantation.

Bartonella henselae has not only been identified as the causative agent of cat scratch disease, but it is also associated with other significant infectious syndromes in the immunocompromised population. We describe two cases of B. henselae associated diseases in liver transplant recipients who both had contact with cats. The first recipient developed localized skin manifestation of bacillary angiomatosis in association with granulomatous hepatitis. He tested positive for Immunoglobulin G (IgG) antibodies against B. henselae. The second patient developed axillary lymphadenopathy, with biopsy showing necrotizing granulomatous inflammation and polymerase chain reaction studies were positive for B. henselae DNA. Her serology for bartonellosis showed a fourfold rise in antibody titers during her hospitalization. Both patients responded to treatment with Azithromycin in combination with Doxycycline. These were the only cases within a series of 467 consecutive liver transplants performed in 402 patients performed during a 4-year period. Although bartonellosis is a rare infection in liver transplantation recipients, it should always be included in the differential diagnosis of patients presenting with fever, central nervous system (CNS) symptoms, skin lesions, lymphadenopathy, and hepatitis especially if prior contact with cats is reported.

Angiomatosis, Bacillary↗
PubMed2005

The expanded spectrum of bartonellosis in children.

Bartonella spp cause various clinical syndromes immunocompetent and immunocompromised hosts. Domestic cats are the natural reservoir, and vectors of B henselae. B henselae infection usually occurs early in childhood, is generally asymptomatic, and in most cases revolves spontaneously. It may, however, produce a wide spectrum of clinical symptoms, the most frequent feature being cat-scratch disease. Disseminated atypical B. henselae infection may follow cat-scratch disease alter a symptom-free period or may present de novo mimicking a wide range of clinical disorders. A careful clinical history researching an intimate contact with a kitten associated with a specific serology and an abdominal ultrasound for typical hepatosplenic involvement may follow a rapid and accurate diagnosis.

Animals↗
PubMed1996

Bartonella (Rochalimaea) infections: beyond cat scratch.

Five species of Bartonella have been found to infect humans, henselae, quintana, elizabethae, bacilliformis, and vinsonii. The most common of these in North America are Bartonella quintana and Bartonella henselae, the agents of trench fever, bacillary angiomatosis, and parenchymal peliosis, and in the case of B. henselae cat-scratch disease. B. bacilliformis is endemic in Peru and Ecuador, where it causes oroya fever or Carrion's disease. New methods of diagnosing Bartonella infections have resulted in increased recognition of the many manifestations of these infections. Early recognition is crucial, as these are potentially fatal opportunistic infections that usually respond rapidly to appropriate antimicrobial therapy.

AIDS-Related Opportunistic Infections↗
PubMed2001

[Unusual manifestations of Bartonella infections].

The authors review the cases of two patients with an atypical form of cat scratch disease. The first case exhibited ileocoecal and hepatoportal lymphadenitis, and the second case the emerging symptoms of a non-specific granulomatous process in the middle third of the right forearm, which caused a differential-diagnostic problem. Establishment of a diagnosis was possible only on the basis of the disease process and the pathological, serological and histopathological pictures of the lymphatic glands after other causes of the lymphadenopathy had been excluded. Following two weeks of antibiotic treatment, the patients were free of complaints- and symptoms. Bartonella antibody tests were performed on 5 cats living in the neighbourhood of the patients with titer determinations too in 3 cases.

Animals↗
PubMed2004

[Study on Bartonella infection using molecular biological diagnostic techniques from China].

OBJECTIVE: To establish polymerase chain reaction (PCR) technique for the detection of specific genes related to species of genus Bartonella, and for diagnosing clinically suspected cat-scratch disease (CSD) case complicated with pneumonia on both lungs. The appearance of Bartonella infectious diseases calls for genus and species detection and tools for identification in order to make clinical diagnosis and carry on epidemiological studies. METHODS: One pair of primer TIle.455p-TAla.885n was designed based on the fact that tRNA(Ile)-tRNA(Ala) intergenic spacer region in 16S-23S rRNA intergenic spacer (ITS) of genus Bartonella were high variable sequences flanked by completely conserved tRNA-encoding genes. 16S-23S rRNA was longer than that which had been described in other bacteria. Two published pairs of primers were used to directly detect the specific gene fragments of Bartonella species DNA extracts from human blood, followed by PCR product Sequencing and nucleotide base sequence analysis. RESULTS: Amplification products of the three pairs of primers had the same predicted size of those in Bartonella spp. According to the different length of electrophoresis bank, the sample was identified as a species of genus Bartonella other than the positive control. Sequence analysis showed that the nuleotide sequence from the PCR product of primer TIle.455p-TAla.885n was identical to the Bartonella isolated from Yunnan in China. CONCLUSIONS: PCR-based assay provided a simple and rapid means to detect pathogenic Bartonella species in humans and mammalian hosts as well as in arthropod vecters. This study suggested that this pathogenic Bartonella species existed in patients in northern and southern parts of China.

Animals↗
PubMed2004

Prevalence of Bartonella henselae in Italian stray cats: evaluation of serology to assess the risk of transmission of Bartonella to humans.

Bartonella henselae is the major etiological agent of cat scratch disease in humans. Cats act as the natural reservoir of B. henselae and can transmit the infection to humans by a bite or scratch. The prevalence of B. henselae in cat populations was evaluated by serological and bacteriological tests. A total of 769 stray cats from three urban and three rural areas in northern Italy were sampled between January 1999 and December 2000. The positive and the negative predictive values of serological tests with respect to bacteremic status were evaluated. Tests of a total of 140 cats (18%) resulted in detection of bacteremia. A total of 540 cats were tested by serology; 207 (38%) were seropositive. Of the 531 cats tested by both methods, the results for 65 (12.2%) showed both bacteremia detection and seropositivity. The molecular typing of the isolates showed that 20.6% of bacteremic cats were infected with B. henselae type I strain, 61.1% were infected with B. henselae type II, and 18.3% were coinfected with both. A statistically significant difference in antibody and bacteremia prevalences among geographical areas was detected. Statistical analysis showed no association between characteristics such as seroprevalence-bacteremic status, sex, general health status, and the presence of ectoparasites. The negative predictive value of serological test was 84.7%, and the positive predictive value was 31.8%. Receiving operator characteristic analysis of the data showed that serological tests had a low predictive value in relation to the bacteremic status of a cat; in surveys aimed at assessing the real risk of B. henselae infection in a human population, therefore, we suggest the use of blood culture as the reference test. Nevertheless, both blood culture assays and serological tests for Bartonella infection should be performed for a complete evaluation of the health status of cats.

Animals↗
PubMedDate not supplied

[Bartonellosis: I. Bartonella henselae].

The recent discovery of the bacterium Bartonella henselae was mainly due to the development of molecular biology techniques adapted to microbial diagnosis and to the description of new human diseases linked to Aids. About 10% of pet cats and 33% of stray cats harbour that bacterium in their blood. In immunocompetent patients, that bacterium is responsible for human cat scratch disease, characterized essentially by a localized lymph nodes enlargement in the vicinity of the entry site of the bacteria. This disease occurs more likely in pet cats less than 1-year-old and infested with fleas. The bacterium is transmitted to humans by scratches or bites; the role of fleas is possible, but is not yet documented. In 5 to 13% of cases, the cat scratch disease appears as more severe, including health impairment, hepatitis, Parinaud's oculo-glandular syndrome, neurological complications or stellate retinitis. In immunocompromised patients, B. henselae is responsible for various clinical presentations: bacillary angiomatosis, bacillary peliosis, recurrent or persistent bacteremia or endocarditis. Diagnosis of infections due to B. henselae can be performed by serological specific testing with sensitivity and specificity values ranging from 75 to 100%. Cultivation of the bacterium is fastidious, particularly in cases of cat scratch disease. The most efficient diagnostic test is the in vitro DNA amplification which has the drawback to require a lymph node sample. Antibiotics are usually inefficient for the treatment of cat scratch disease. By contrast, in immunocompromised patients, these infections are successfully treated for a more or less long time by macrolides or tetracyclines or rifampin.

Animals↗
PubMed1999

Culture of Bartonella quintana and Bartonella henselae from human samples: a 5-year experience (1993 to 1998).

Bartonella quintana and Bartonella henselae are fastidious gram-negative bacteria responsible for bacillary angiomatosis, trench fever, cat scratch disease, and endocarditis. During a 5-year period, we received 2,043 samples for culture of Bartonella sp. We found Bartonella sp. to be the etiologic agent in 38 cases of endocarditis, 78 cases of cat scratch disease, 16 cases of bacteremia in homeless people, and 7 cases of bacillary angiomatosis. We correlated the results of positive cultures with the clinical form of the disease, type of sample, culture procedure, PCR-based genomic detection, and antibody determination. Seventy-two isolates of B. quintana and nine isolates of B. henselae from 43 patients were obtained. Sixty-three of the B. quintana isolates and two of the B. henselae isolates, obtained from patients with no prior antibiotic therapy, were stably subcultured. The sensitivity of culture was low when compared with that of PCR-based detection methods in valves of patients with endocarditis (44 and 81%, respectively), skin biopsy samples of patients with bacillary angiomatosis (43 and 100%, respectively), and lymph nodes of cat scratch disease (13 and 30%, respectively). Serological diagnosis was also more sensitive in cases of endocarditis (97%) and cat scratch disease (90%). Among endocarditis patients, the sensitivity of the shell vial culture assay was 28% when inoculated with blood samples and 44% when inoculated with valvular biopsy samples, and the sensitivity of both was significantly higher than that of culture on agar (5% for blood [P = 0.045] and 4% for valve biopsy samples [P < 0.0005]). The most efficient culture procedure was the subculture of blood culture broth into shell vials (sensitivity, 71%). For patients with endocarditis, previous antibiotic therapy significantly affected results of blood culture; no patient who had been administered antibiotics yielded a positive blood culture, whereas 80% of patients with no previous antibiotic therapy yielded positive blood cultures (P = 0.0006). Previous antibiotic therapy did not, however, prevent isolation of Bartonella sp. from cardiac valves but did prevent the establishment of strains, as none of the 15 isolates from treated patients could be successfully subcultured. For the diagnosis of B. quintana bacteremia in homeless people, the efficiency of systematic subculture of blood culture broth onto agar was higher than that of direct blood plating (respective sensitivities, 98 and 10% [P < 10(-7)]). Nevertheless, both procedures are complementary, since when used together their sensitivity reached 100%. All homeless people with positive blood cultures had negative serology. The isolation rate of B. henselae from PCR-positive lymph nodes, in patients with cat scratch disease, was significantly lower than that from valves of endocarditis patients and skin biopsy samples from bacillary angiomatosis patients (13 and 33%, respectively [P = 0.084]). In cases of bacillary angiomatosis for which an agent was identified to species level, the isolation rate of B. henselae was lower than the isolation rate of B. quintana (28 and 64%, respectively [P = 0.003]). If culture is to be considered an efficient tool for the diagnosis of several Bartonella-related diseases, methodologies need to be improved, notably for the recovery of B. henselae from lymph nodes of patients with cat scratch disease.

Angiomatosis, Bacillary↗